Association Between Gout and Aortic Stenosis

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• 作者：Kevin Chang ; MD^a ; ^b ; ^c ; ¹ ; Chio Yokose ; MD^a ; ^b ; ^c ; ¹ ; Craig Tenner ; MD^c ; ^d ; ^e ; Cheongeun Oh ; PhD^c ; ^f ; Robert Donnino ; MD^c ; ^g ; ^h ; ⁱ ; Alana Choy-Shan ; MD^c ; ^g ; ^h ; Virginia C. Pike ; BA^a ; ^b ; ^c ; Binita D. Shah ; MD ; MS^c ; ^g ; ^h ; Jeffrey D. Lorin ; MD^c ; ^g ; ^h ; Svetlana Krasnokutsky ; MD ; MS^a ; ^b ; ^c ; ¹ ; Steven P. Sedlis ; MD^c ; ^g ; ^h ; ¹ ; Michael H. Pillinger ; MD^a ; ^b ; ^c ; ¹ ; ^{Michael.Pillinger@nyumc.org}
• 关键词：Aortic stenosis ; Gout ; Valvular heart disease
• 刊名：The American Journal of Medicine
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：130
• 期：2
• 页码：230.e1-230.e8
• 全文大小：302 K
• 卷排序：130

文摘

An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis.MethodsWe performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis. Charts were reviewed to identify diagnoses of gout and the earliest dates of gout and aortic stenosis diagnosis.ResultsAmong 1085 patients who underwent TTE, 112 aortic stenosis cases were identified. Cases and nonaortic stenosis controls (n = 224) were similar in age and cardiovascular comorbidities. A history of gout was present in 21.4% (n = 24) of aortic stenosis subjects compared with 12.5% (n = 28) of controls (unadjusted odds ratio 1.90, 95% confidence interval 1.05-3.48, P = .038). Multivariate analysis retained significance only for gout (adjusted odds ratio 2.08, 95% confidence interval 1.00-4.32, P = .049). Among subjects with aortic stenosis and gout, gout diagnosis preceded aortic stenosis diagnosis by 5.8 ± 1.6 years. The age at onset of aortic stenosis was similar among patients with and without gout (78.7 ± 1.8 vs 75.8 ± 1.0 years old, P = .16).ConclusionsAortic stenosis patients had a markedly higher prevalence of precedent gout than age-matched controls. Whether gout is a marker of, or a risk factor for, the development of aortic stenosis remains uncertain. Studies investigating the potential role of gout in the pathophysiology of aortic stenosis are warranted and could have therapeutic implications.